Sinus of Valsalva aneurysm rupture is a potentially fatal condition that requires urgent surgical intervention. We report a case of right sinus of Valsalva aneurysm rupture into the right atrium in a patient with a monocuspid aortic valve successfully managed with femoral venoarterial extracorporeal membrane oxygenation after pulseless electrical activity cardiac arrest to facilitate complete surgical repair. The patient made a full recovery and was discharged home with no neurologic deficit and had no limitations at the 1-year follow-up.
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